HESI RN
HESI Leadership and Management
1. A client with a nasogastric tube requires irrigation once every shift. The client's serum electrolyte results show a potassium level of 4.5 mEq/L and a sodium level of 132 mEq/L. Based on these findings, which solution should the nurse use for nasogastric tube irrigation?
- A. Tap water
- B. Sterile water
- C. Sodium chloride
- D. Normal saline
Correct answer: C
Rationale: The correct solution for nasogastric tube irrigation in this scenario is sodium chloride. The client's low sodium level of 132 mEq/L indicates the need to avoid further imbalance, making sodium chloride the most appropriate choice. Using tap water, which lacks electrolytes, or sterile water could potentially exacerbate the electrolyte imbalance. Normal saline, while similar to sodium chloride, may not be the best choice as it contains a higher concentration of sodium, which could further elevate the client's already borderline sodium level.
2. The healthcare provider is caring for a client with Cushing's syndrome. Which of the following nursing interventions is appropriate?
- A. Monitor blood glucose levels
- B. Restrict fluid intake
- C. Administer potassium supplements
- D. Encourage a high-protein diet
Correct answer: A
Rationale: Clients with Cushing's syndrome are at risk for hyperglycemia due to the effects of cortisol on glucose metabolism. Monitoring blood glucose levels is crucial to detect and manage hyperglycemia promptly. Restricting fluid intake (choice B) is not necessary unless specifically indicated for another condition, as clients with Cushing's syndrome are prone to fluid imbalances. Administering potassium supplements (choice C) is not appropriate as clients with Cushing's syndrome often have elevated potassium levels due to the effects of cortisol. Encouraging a high-protein diet (choice D) is not recommended as clients with Cushing's syndrome should focus on a balanced diet to manage their condition effectively.
3. A client with Addison's disease is at risk for which of the following complications?
- A. Hypertension
- B. Hypovolemia
- C. Hypernatremia
- D. Hypokalemia
Correct answer: B
Rationale: A client with Addison's disease is at risk for hypovolemia. Addison's disease is characterized by adrenal insufficiency, particularly cortisol and aldosterone deficiency. Aldosterone deficiency leads to impaired sodium and water retention, resulting in decreased blood volume and hypovolemia. This condition can cause hypotension, not hypertension (Choice A), as reduced blood volume leads to decreased pressure. Hypernatremia (Choice C) is unlikely in Addison's disease because of the loss of sodium along with water in hypovolemia. Hypokalemia (Choice D) can occur due to aldosterone deficiency, but it is not the primary complication associated with Addison's disease.
4. Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find:
- A. Hypotension.
- B. Thick, coarse skin.
- C. Deposits of adipose tissue in the trunk and dorsocervical area.
- D. Weight gain in arms and legs.
Correct answer: C
Rationale: In Cushing's syndrome, the characteristic features include central obesity with deposits of adipose tissue in the trunk and dorsocervical area, often referred to as a 'buffalo hump.' Hypotension (Choice A) is not typically associated with Cushing's syndrome; instead, hypertension is more common. Thick, coarse skin (Choice B) is seen in conditions like hypothyroidism, not specifically in Cushing's syndrome. Weight gain in the arms and legs (Choice D) is not a typical finding in Cushing's syndrome; rather, weight gain is more prominent in the central areas of the body.
5. The nurse is caring for a client with hypothyroidism. Which of the following clinical findings should the nurse expect?
- A. Tachycardia
- B. Weight loss
- C. Cold intolerance
- D. Diaphoresis
Correct answer: C
Rationale: Cold intolerance is a classic symptom of hypothyroidism. In hypothyroidism, the body's metabolic rate is decreased, leading to a decreased ability to regulate body temperature. This results in a feeling of being cold most of the time. Tachycardia (Choice A) is more commonly associated with hyperthyroidism, not hypothyroidism. Weight loss (Choice B) and diaphoresis (Choice D) are also more characteristic of hyperthyroidism, where there is an increased metabolic rate and excess heat production.
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